Provider Demographics
NPI:1497198303
Name:STEWARD ST. ANNE'S HOSPITAL CORP. REGINAL CANCER CENTER
Entity Type:Organization
Organization Name:STEWARD ST. ANNE'S HOSPITAL CORP. REGINAL CANCER CENTER
Other - Org Name:STEWARD ST. ANNE'S HOSPITAL CORP. REGIONAL CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-674-5600
Mailing Address - Street 1:537 FAUNCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1242
Mailing Address - Country:US
Mailing Address - Phone:508-961-0710
Mailing Address - Fax:
Practice Address - Street 1:537 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1242
Practice Address - Country:US
Practice Address - Phone:508-961-0710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA00588473336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139786OtherPK